RN Care Coordinator
Company: Optum
Location: Pleasant Hill
Posted on: January 27, 2025
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Job Description:
$7,500 Sign-on Bonus for External Candidates!
M-F No nights, weekends or on-call!
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For those who want to invent the future of health care, here's your
opportunity. We're going beyond basic care to health programs
integrated across the entire continuum of care. Join us to start
Caring. Connecting. Growing together.
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An RN functions as part of the primary care team, and reports to
the Clinical Services Manager (CSM). -The supports the APC and our
members to coordinate care services. This role works in close
collaboration with all of the team members, and may support
multiple providers. The RN works under the direction of the
provider, and activities are delegated to the RN by the provider or
the team CSM. The RN understands and supports the CPM models of
care Institutional Special Needs Plan (ISNP), Institutional Special
Needs Plan (IESNP) and Transitions to Skilled (TTS) and works in
collaboration with the team to meet the goals of the program. This
role will support our members telephonically and in- person in
patient settings and home settings. -
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Primary Responsibilities: -
Establishes and maintains communication and a trusting
collaborative relationship with the ICT, member/RP and primary
caregiver staff in the ALC and APC--- -
Communicates with multiple organizations operational units for
seamless coordination of benefits, i.e., utilization review staff,
provider relations liaison, pharmacy, etc.--- -
Reviews member's status and assists to achieve progress toward
goals; adjusts the ICP as necessary--- -
Performs administrative functions for or on behalf of the PCP
and/or APC--- -
Participates in program effectiveness analysis and planning---
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Performs member visits and rounding as established and directed by
the APC--- -
Communicates status of member with APC for evaluation and ICP
updates--- -
Communicates with member, family/RP, primary caregivers of the
community and other members of the ICT with each member visit---
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Assists with other clinical and quality responsibilities for
member, e.g., gaps in care--- -
Attends meetings on behalf of the APC and communicates updates to
the ICP with the ICT--- -
Provides clinical educational programs for facility staff--- -
Communicates information on behalf of the APC to the member,
family/RP and primary caregiver staff at the ALC--- -
Coordinates and collaborates with the health plan/client--- -
Assists with ACP--- -
Performs collection of data including functional status, BMI, vital
signs, urine test for proteinuria, IFOBT specimen collection, and
other clinical data. Results are entered into EMR and reviewed by
APC--- -
Performs care coordination activities within the ALC to ensure
member needs are met. (i.e., member---external provider
appointments, therapy needs,--- durable medical equipment (DME) and
transportation)------ -
Stays abreast of all Model of Care (MOC) , documentation and policy
updates communicated email, newsletters and team meetings--- -
Maintains an understanding of and utilizes clinical resources
independently including but not limited to Resource1,
iCoreCodeGenius, Sparq, Learnsource and other Optum internal
sites
Maintains confidential health information according to state and
federal regulations including HIPAA--- -
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You'll be rewarded and recognized for your performance in an
environment that will challenge you and give you clear direction on
what it takes to succeed in your role as well as provide
development for other roles you may be interested in.Required
Qualifications: -
Current unrestricted Registered Nurse license in Oregon
3+ years of RN experience -
1+ years of case management experience
Experience with using an electronic medical records -
Demonstrated basic Microsoft Office skills with the ability to
navigate in a Window's environment -
Proven excellent communication and customer service skills
Valid driver's license and the ability to travel locally 75% of the
time
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Preferred Qualifications: -
BSN
Experience working in post- acute care, such as long term care or
hospice and/or Case Management experience as an RN
Experience working with the geriatric population
Familiarity with the long-term care business environment
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At UnitedHealth Group, our mission is to help people live healthier
lives and make the health system work better for everyone. We
believe everyone-of every race, gender, sexuality, age, location
and income-deserves the opportunity to live their healthiest life.
Today, however, there are still far too many barriers to good
health which are disproportionately experienced by people of color,
historically marginalized groups and those with lower incomes. We
are committed to mitigating our impact on the environment and
enabling and delivering equitable care that addresses health
disparities and improves health outcomes - an enterprise priority
reflected in our mission.
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Diversity creates a healthier atmosphere: OptumCare is an Equal
Employment Opportunity/Affirmative Action employers and all
qualified applicants will receive consideration for employment
without regard to race, color, religion, sex, age, national origin,
protected veteran status, disability status, sexual orientation,
gender identity or expression, marital status, genetic information,
or any other characteristic protected by law.
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OptumCare is a drug-free workplace. Candidates are required to pass
a drug test before beginning employment.
Keywords: Optum, Springfield , RN Care Coordinator, Healthcare , Pleasant Hill, Oregon
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